Homebirth? - Mothering Forums
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December 2011 > Homebirth?
Gemmine's Avatar Gemmine 12:36 PM 04-03-2011

Who is doing it? Who has done it and is doing it again? Who has done it and will not do it again?

 

I'm planning homebirth for our 1st. I'm so overwhelmed, I don't know where to begin! I start interviewing midwives this week. I wonder how payment works out when you have insurance, etc. Do the midwives help you make sure you get stuff covered?

 

I figured this could be a thread where we all ask and answer questions and support each other.



Mummoth's Avatar Mummoth 01:05 PM 04-03-2011

I've had 2 home births, and will plan another one, but with different midwives this time. My previous midwives were awesome, but they're quite far to get to, and there's one walking distance to me now! As long as we click with the neighbourhood one, I'll be going with her. I kind of don't want to use the same midwives because I was with my ex when I had the older kids... it just doesn't feel right.

 

I can't help with billing, midwives are covered my the medical services plan here, they even have hospital privileges. The only thing I have to buy are chux pads, life savers and bendy straws.

 

I know it feels overwhelming, but there's not a lot you have to DO yet... pregnancy is like 95% hurry up and wait. At least we don't have to sit on  a nest!!


ashleeS's Avatar ashleeS 03:01 PM 04-03-2011

This will be our third homebirth.  Its the only way we've done it.  I didn't have insurance with the first...so that was part of our reason for a homebirth, but I was already very open and familiar with the idea.  Anyway, because we have an HMO plan now, having insurance only helps in the chance there is an emergency, transfer,etc.  My sister has fantastic insurance and is always reimbursed for the midwife costs.  So, yes, if you have a great plan you may get reimbursed...but usually after you have had the baby...which means after you have paid midwife in full - most want full payment by 36 weeks.  Essentially you will be the one getting the check from insurance, not midwife.  Our midwife does have a referral that helps with insurance billing.  You'll find there is great variety in these details! 

 

Caitlin0919's Avatar Caitlin0919 03:07 PM 04-03-2011

DH and I might be having an UC, depending on how we feel about the hospital here. DD was born in a hospital in my hometown and the birth went nearly perfect. We moved from there in November so we don't know much about the hospital system here. It's illegal for midwives to attend homebirths in South Dakota, otherwise we wouldn't be doing it unassisted. I've heard of one or two midwives that attend homebirths "underground" but we're 100 miles away from the area they serve so that's not really an option. We're still going to tour the hospital and make a birth plan and discuss all that stuff with the OB just in case we decide to do it there or we decide to transfer in labor. I'm still trying to get as much info as I can about homebirth and UC to help us decide for sure.


Norabella's Avatar Norabella 06:05 PM 04-03-2011

My DD was an awesome homebirth and we will plan another one, with the same midwife for this baby. My midwife bills insurance directly and then sends a bill for what insurance doesn't cover, and tends to "discount" the non-insurance covered portion so much that we actually paid her more than what she billed for DD because we thought she was really underpaying herself.


onetwoten's Avatar onetwoten 11:46 PM 04-03-2011

I'm in Canada like Mummoth, so ours are 100% covered, I can't help with billing.

 

I'm crossing my fingers right now to hear back from a midwife though... They are in extremely high demand in Manitoba, to the point where they can pick and choose who they take and who they pass on. I'm worried that somehow I "won't make it" and won't be able to get a midwife. I've been intaked at all four midwife offices in our city (there's about 20 midwives total) and I was told i would hear back within two weeks-- which gives me until Friday.

 

If we somehow don't get a midwife, then I will find an OB for care, and hopefully start planning a UC. DH is a paramedic, and I have some doula experience (I'll be doing it full time after we have the baby, but i'm on hiatus for now), so I'm not all that worried about it, but DH is trained to think of all the horror cases, so he's not 100% sold on it. I very much don't want to birth in a hospital though.


SierraBella's Avatar SierraBella 08:00 AM 04-04-2011

This is my first homebirth. I've had my other 2 all natural however.

 

Like Mummoth, this baby is with a different father than my other 2, and I also feel a little weird about having my other midwife there, and she is a little too far away now that I've moved 60 miles away from where I was. Tomorrow I have an appt with another midwife who is very well respected in my state and is highly recommended by some mama friends of mine.

 

As for payment- I've had medicaid with my other 2 and plan to this time as well. But Medicaid doesn't cover homebirths, I get it in case I have to go to the hospital and to cover tests, dental, and chiropractic. I paid out of pocket for my birth with #2 at the birth center. My midwife worked with me on a payment plan.


Gemmine's Avatar Gemmine 09:34 AM 04-04-2011

This is awesome info everyone.

 

I'm working on my list of questions for the midwife interviews this week. Does anyone have "must-ask" questions to share?


ThePottersDaughter's Avatar ThePottersDaughter 10:37 AM 04-04-2011

This will be our 3rd child, 2nd homebirth. I would not have it any other way. Night and day.

 

Our insurance doesn't cover it but depending on what kind of insurance you have, it could be cheaper anyway. Midwives around here run about $2,600. That's with all of the prenatal and post partum care. A lot of my friends have paid way more than that in co pays for a hospital birth. One friend even had a natural hospital birth, arriving right before she had to push, and she ended up paying out of pocket about $3,000- and that didn't even include her prenatal and postpartum co pays!

 

I think one good question to ask a midwife is whether she has a tub that you can rent from her. I wasn't sure if I wanted a tub, and was pretty sure I didn't want to have the baby in the water but as soon as it came time to push I said, "Get me in that tub!" lol. I know it would not have been such a pleasant experience had I not been able to push him out in the water. Something to think about! :)


Mummoth's Avatar Mummoth 11:28 AM 04-04-2011

One thing to ask if this would bother you is, if the midwife is a smoker. I never knew until mine came over for a post/natal visit and she was holding my son and had obviously had a cigarette on her way over. I gave him a bath as soon as she left shy.gif


Mayachel's Avatar Mayachel 11:52 AM 04-04-2011

We're planning a homebirth! This is my first pregnancy, but I am a long time doula and an about to graduate midwifery student. I feel I've seen enough births in the variety of hospitals, birth centers and homes that NY has to offer, and would only be willing to deliver in the hospital if there was an emergent need to do so. 

 

The MW i'm planning to use takes most insurances including HMO/medicaid plans. She also has a sliding scale/payment plan for people without insurance. Other than that, I don't yet know how her billing system works. 

 

Personally, I think MW can look very similar on paper, lots of experience, good outcomes, support normal physiology of birth yadda yadda. So for me, once you take those things as a given, I think it is much more important that both you and your partner if they will be involved with the birth, are 100% on board with trusting and matching in personality of your MW. Although non-smoker is a great point. I would not be happy if someone showed up to my home smelling of cigarette smoke while I was in labor. 

 

Some other things that I want to know:

-who is your back up/do I get to meet them?

-what circumstances would risk me out of hb?

-how far past my due date are you comfortable with and why?

-should we need to transfer to a hospital, which one would it be, do you have privileges there, who is the doctor that would be backing us?

-what circumstances would necessitate a transfer?

-have you managed complications in the past like hemorrhage and shoulder dystocias? 

-what medicine/herbs do you bring with you? (I would want them to bring some form of anti-hemorrhage meds and an IV and fluid set up jic)

 


Gemmine's Avatar Gemmine 02:00 PM 04-04-2011

Thank you guys, I'm taking notes!


ElizaBird's Avatar ElizaBird 06:21 PM 04-04-2011

I'll plan for a homebirth again, for sure.

My twins, six years ago, were born at home with the midwife i was apprenticing with at the time. 

She was a homebirth CNM, and our

state medicaid for pregnant women covered all of her services, including the homebirth! I'm not sure whether medicaid covers CPM attended birth here or not- it sounds like that is rare. Plus i don't think i'll qualify this time (right now i'm uninsured eyesroll.gif).

 

But that midwife is no longer attending births (She's teaching in the Yale Nurse-Midwifery Program!), so I'll be looking into the other midwives in my area. I'm also letting the idea of a UC simmer for a while, though I'm not sure. I like the support a midwife can offer.

My mom is about to graduate from a nurse-midwifery program: maybe i'll even have her attend me!     we'll see. I'm not feeling much urgency about all this yet.

 

Here's to all considering homebirth!   I am such an fan.     stillheart.gif

 


Panonim's Avatar Panonim 10:00 PM 04-04-2011

Oh, me, me!  We are definitely planning another homebirth this time around - it's one of the things I'm most excited about!  orngbiggrin.gif  This is our 3rd baby and will be our 2nd homebirth.  I'm also in Canada so can't comment on the insurance thing.  Left a voicemail with our MW's office last night asking to be taken on as a client again.  Haven't heard back from her yet but we are *praying* she can take us!  (In my city there is a pathetically low number of homebirth midwives, so you pretty much have to phone the day you get your BFP to reserve a spot).


stephck's Avatar stephck 08:02 AM 04-06-2011

I'm a little jealous of the Canadians!  

 

It stinks that money is a factor in our healthcare.  With my insurance, I can have a hospital birth for $15.  That's all the prenatal visits delivery etc.  My insurance does not cover home birth, which runs about $4500 here.  So we met with a homebirth midwife and we're going to meet with the hospital midwife and we'll see.  Baby #1 was at a birthing center (a real one, not a hospital called one) and all went well, so I'd really love a homebirth.  But I also pay a lot of money monthly for my insurance and don't know if we can justify it financially to double pay for our healthcare.


onetwoten's Avatar onetwoten 10:40 AM 04-06-2011

We got the pros and the cons of our midwives being covered. It's free---- but... they are also in higher demand in most cities. My stomach is a wreck right now waiting to hear back if we got accepted or not. If we don't, other than get put on a waiting list, I don't know what to do next. The thought of birthing in a hospital makes me cringe. Ugh.

 

Thinking positive, productive thoughts.


Panonim's Avatar Panonim 02:18 PM 04-06-2011


Quote:
Originally Posted by jeninejessica View Post

We got the pros and the cons of our midwives being covered. It's free---- but... they are also in higher demand in most cities. My stomach is a wreck right now waiting to hear back if we got accepted or not. If we don't, other than get put on a waiting list, I don't know what to do next. The thought of birthing in a hospital makes me cringe. Ugh.

 

Thinking positive, productive thoughts.


Exactly this!   

 



Quote:
Originally Posted by stephck View Post

I'm a little jealous of the Canadians!  

 

It stinks that money is a factor in our healthcare.  With my insurance, I can have a hospital birth for $15.  That's all the prenatal visits delivery etc.  My insurance does not cover home birth, which runs about $4500 here.  So we met with a homebirth midwife and we're going to meet with the hospital midwife and we'll see.  Baby #1 was at a birthing center (a real one, not a hospital called one) and all went well, so I'd really love a homebirth.  But I also pay a lot of money monthly for my insurance and don't know if we can justify it financially to double pay for our healthcare.



 

You know, up until 2 years ago in the province of Alberta (I'm not sure about other Canadian provinces), midwifery was not funded by our universal health care plan.  Our DD was born in a hospital in 06, of course her birth was 100% covered, and we paid nothing for it.  Our DS was born at home in 08, and at the time, we had to pay out of pocket (which is SO unusual here that it is a hard concept to grasp for us - paying for health care!).  Our homebirth cost us $3000.  We are SO fortunate that at the time, we were able to pay.  In 2009, Alberta *finally* started covering midwifery services under the health care plan, and so for a homebirth for this pregnancy, we will pay nothing.  Thank God, because this time around, we could NOT afford $3000 and would probably be stuck with a hospital birth or UC, neither of which are choices we want.


goldenwillow's Avatar goldenwillow 02:27 PM 04-06-2011


Quote:
Originally Posted by Gemmine View Post

Who is doing it? Who has done it and is doing it again? Who has done it and will not do it again?

 

I'm planning homebirth for our 1st. I'm so overwhelmed, I don't know where to begin! I start interviewing midwives this week. I wonder how payment works out when you have insurance, etc. Do the midwives help you make sure you get stuff covered?

 

I figured this could be a thread where we all ask and answer questions and support each other.


Take a breath and breathe deep. 

 

We had a fantastic water homebirth and if I wanted to have another babe... I would do it again, and again and again, no doubt.  There is no comparison. 

 

I had insurance through my past employer and my MW had me sign up for Medicaid as a supplemental. 

 

I think the questions you read here will help a ton.  They also come to you if you just have a pen and paper out on a table to write down your thoughts as they come.  A great MW will have a presence about her and IMHO, you will just know if she is the one to assist you. 

 

 

 


goldenwillow's Avatar goldenwillow 02:30 PM 04-06-2011


Quote:
Originally Posted by Mummoth View Post

One thing to ask if this would bother you is, if the midwife is a smoker. I never knew until mine came over for a post/natal visit and she was holding my son and had obviously had a cigarette on her way over. I gave him a bath as soon as she left shy.gif


Arghh.... that is horrible!

 

 

 


onetwoten's Avatar onetwoten 02:38 PM 04-06-2011

Quote:

Originally Posted by Panonim View Post

You know, up until 2 years ago in the province of Alberta (I'm not sure about other Canadian provinces), midwifery was not funded by our universal health care plan.  Our DD was born in a hospital in 06, of course her birth was 100% covered, and we paid nothing for it.  Our DS was born at home in 08, and at the time, we had to pay out of pocket (which is SO unusual here that it is a hard concept to grasp for us - paying for health care!).  Our homebirth cost us $3000.  We are SO fortunate that at the time, we were able to pay.  In 2009, Alberta *finally* started covering midwifery services under the health care plan, and so for a homebirth for this pregnancy, we will pay nothing.  Thank God, because this time around, we could NOT afford $3000 and would probably be stuck with a hospital birth or UC, neither of which are choices we want.

 

Yeah... I'm very supportive of UC, and would love to do it for future births, but I hate the idea of it being the only option due to cost concerns. I think UC is a very personal decision that you need to take a lot of responsibility for, but I've heard several people who chose UC not because they are confident in their abilities, but because it's the only option they can afford. That's both sad and frightening.

 

Homebirth is a huge priority for us... but like you, if it came to paying out of pocket for it right now, I'm not sure what we would do. We have a basement that needs to be renoed right now so that we will no outgrow this house. $3000 for a birth would be half of our reno costs. I can't imagine being in a place where I had to weigh what to pay for. I don't envy the choices you guys have to make in the states.


mrslainez's Avatar mrslainez 04:01 PM 04-06-2011

i'd love to have a home birth but our apartment is quite small.  i wouldn't be comfortable with everyone we want to attend the birth being crammed in here like sardines.  it might be possible if we find a larger apartment in time, but a water birth at the birth center is our current plan.  i'm also unsure if the midwife i've been assigned to assists with home births because i haven't met her yet.


onetwoten's Avatar onetwoten 04:28 PM 04-06-2011

It's worth considering how many people you would be allowed to have in the hospital birthing room or birthing centre as well. Several hospitals will only let you have one or two companions.  Not to say that this means you should definately have a homebirth, but just something to consider. I know both hospitals here would be a lot more crowded than my home if I were to have more than two support people, and our birth centre hasn't opened yet, but based on drawings and mockups, it won't be much different.

 

That said, I'm hoping that our homebirth will have the opposite effect-- we don't want a ton of family, and I feel like they will be less likely to invite themselves to our home, than to a hospital where they can say "well we'll just wait in the waiting room..."  That's my hope anyways!


mrslainez's Avatar mrslainez 04:37 PM 04-06-2011

the website of the birth center says that entire families are welcome to attend the birth.  i think we'll have 4-5 attendees: our parents and my nana.  (i dunno if my father-in-law will attend or not.)  it may not sound like a whole lot, but lacking a living room, that's definitely a crowd!


SierraBella's Avatar SierraBella 07:56 AM 04-07-2011

For our homebirth we'll have my midwife, my doula (hopefully! She lives about 1 1/2 hours away), DH, and a friend of mine in nursing school wants to see an all natural homebirth and I told her she could come too. I am also considering having a professional photographer, lol, and it's possible that my midwife's assistant would be there as well. Possibly my older children too, but I will likely have my sister come pick them up or they can be with their father during the birth (if my Ex isn't a total jerk at the time).


goldenwillow's Avatar goldenwillow 08:43 AM 04-07-2011


Quote:
Originally Posted by SierraBella View Post

For our homebirth we'll have my midwife, my doula (hopefully! She lives about 1 1/2 hours away), DH, and a friend of mine in nursing school wants to see an all natural homebirth and I told her she could come too. I am also considering having a professional photographer, lol, and it's possible that my midwife's assistant would be there as well. Possibly my older children too, but I will likely have my sister come pick them up or they can be with their father during the birth (if my Ex isn't a total jerk at the time).



Whoa!  Having a party!  Too many for this girl! 


Mummoth's Avatar Mummoth 10:51 AM 04-07-2011

I made my first appointment with the midwifes... it's on the 19th. I haven't given any thought to who will be here for the birth... SO and the midwives, obviously. I don't know how the kids will feel about being here, but it'll be up to them. My mom was at my other 2 births, and probably will be there for the kids again... but I'll want to see how SO feels about that.


onetwoten's Avatar onetwoten 03:36 PM 04-07-2011

Our plan (If I ever hear back from the midwives office...) is for it to be just DH and I, the two midwives, and then a doula/birth photographer. If I can't find a doula who feels confident with a camera, then I suppose two different people, but I really want to limit the number. I'm much more likely to hide off with DH somewhere, and I'm positive that if I have family over it will make me clam up. I shudder thinking of it.


Lisa85's Avatar Lisa85 05:35 PM 04-07-2011

We are having homebirth.  The one thing I haven't figured out yet is what to do with the kids.  I really don't want to send them off to family, plus I think they deserve to be included, if they so choose.  But, if they get bored or freaked out at a time when I need dh's support, or the actual birth which he'd hate to miss.  I wish I had a friend I felt comfortable enough with and knew well enough to ask and come watch them.


Mayachel's Avatar Mayachel 05:40 PM 04-07-2011

Ha! I'm encouraged to hear I'm not the only one who hasn't heard back from her midwife yet, and super excited for those of you with your first visit already on the calendar! I mentioned it to my mom the other day, because though I know she's known I've always intended to have a homebirth I know she's not 100% on board with it at the moment. I told her she could start considering if she wanted to be at the birth or not. I feel like when the time comes, she'll be very supportive of me, even if it is totally out of her realm of comfort. I feel that my good friend/mw who will hopefully be able to be there as my doula will help put her at ease and that our home is divided up well that if I want privacy, or she isn't handling it well, we can be in different parts easily.


I always imagined that I would have a small handful of girlfriends around, to have a party in our main living room, and be there if I needed/wanted them, but out of the way if not. Now, I'm not so sure. It might be easier to just have my dh, friend and mw. Plenty of time to figure it all out.


abc123xyz's Avatar abc123xyz 08:27 PM 04-07-2011

We are having our 2 1/2  homebirth!!! LOL (first was a planned homebirth, transferred after 40 hours, had baby 5 hrs later) Our midwife charged a flat $2500 for everything. In our state, homebirth midwives are illegal so insurance covers nothing! But our hospital birth with ended up costing us $1000 anyways PLUS all we would have had to pay in co-pays if we did the Dr. route. The second time, we did a partial UC, our best friend is a retired midwife. We paid her a gift amount since we had few "prenatal" visits and she was present for our birth but was little involved. AND she's our neighbor so she had no travel! This time, she will be present too and we will gift her again!!!! I am so excited! My last was a surprise breech so I am eager to have a "normal" birth!!!! Just once! I am praying for it! I know it will go exactly as it's suppose to but I would love to water birth this time if possible!


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